ON-COLOUR - Investigating vascular predictors of poor visual outcome in the multidisciplinary management of immune-mediated optic neuritis
Abstract:
Irreversible visual loss (up to blindness) is one frequent outcomes of optic neuritis (ON), an acute inflammatory demyelinating event, occurring isolated or as first clinical manifestation of immune-mediated diseases of the central nervous system (CNS). Approx. 50% of ON patients eventually develop multiple sclerosis (MS), a highly disabling disorder of the CNS. Magnetic resonance imaging (MRI) characteristics and optical coherence tomography (OCT) are the state of the art diagnostic tools of ON.
Too simplistically the term ‘optic neuritis’ is found in association to an inflammatory optic neuropathy, in relation to MS and neuromyelitis optica spectrum disorders (NMOSD). ON is indeed a much more complex condition, of partially unraveled nature and with only suboptimal management. An involvement of the optic nerve is reported in a number of other autoimmune/immune-mediated non-demyelinating systemic disorders (eg., neuro-Behcet disease, CNS primary angiitis).
Because of the putatively inflammatory nature, treating ON typically relies on high-dose iv. However, visual acuity may never recover completely. Steroid-refractory ON are reported in up to 50% of individuals with ON and within different underlying conditions, such as MS and NMOSD.
ON-COLOUR rationale lies in 4 main issues: (1)lack of consistent nosological classification, (2) inconsistently performed diagnostic pathway, (3) overlooking of potentially relevant but neglected prognostic factors (eg., cerebral hypoperfusion), (4) lack of a multidisciplinary care pathway in the management of ON.
ON-COLOUR specifically aims to (1) investigate the distribution of ON across different Italian hospital-based settings, (2) detect and characterize a ‘small vessel’ disease of the optic nerve and related prognosticrole, (3) design an integrated diagnostic and prognostic algorithm, (4) provide cost-of-illness data of ON.
ON-COLOUR methodology will imply 9 WPs with focus on ON epidemiological descriptive and analytical studies, the search for vessel disorders, CSF and serum cytokines with vasoactive action, a cost and quality of life studies, and the ultimate development of a prognostic algorithm to optimize ON care.
ON-COLOUR will go beyond the state of the art for (1) scientific knowledge as it will contribute to the refinement of diagnostic criteria, incl., MS and NMOSD, will disclose/enhance knowledge about vessel disease in ON, will disclose prognostic factors, (2) technical knowledge (use of ultrasound in the investigation of inflammation in optic nerve), (3) education, (4) patients’ care through the application of a multidisciplinary integrated algorithm.
ON-COLOUR Research Team consists of neurologists, ophthalmologists and rheumatologists with specific expertise in optic neuropathies, located at the Universities of Ferrara (PI), Naples, Sassari and Udine, and including the IRCCS Casa Sollievo Sofferenza, S. Giovanni Rotondo (FG).
Too simplistically the term ‘optic neuritis’ is found in association to an inflammatory optic neuropathy, in relation to MS and neuromyelitis optica spectrum disorders (NMOSD). ON is indeed a much more complex condition, of partially unraveled nature and with only suboptimal management. An involvement of the optic nerve is reported in a number of other autoimmune/immune-mediated non-demyelinating systemic disorders (eg., neuro-Behcet disease, CNS primary angiitis).
Because of the putatively inflammatory nature, treating ON typically relies on high-dose iv. However, visual acuity may never recover completely. Steroid-refractory ON are reported in up to 50% of individuals with ON and within different underlying conditions, such as MS and NMOSD.
ON-COLOUR rationale lies in 4 main issues: (1)lack of consistent nosological classification, (2) inconsistently performed diagnostic pathway, (3) overlooking of potentially relevant but neglected prognostic factors (eg., cerebral hypoperfusion), (4) lack of a multidisciplinary care pathway in the management of ON.
ON-COLOUR specifically aims to (1) investigate the distribution of ON across different Italian hospital-based settings, (2) detect and characterize a ‘small vessel’ disease of the optic nerve and related prognosticrole, (3) design an integrated diagnostic and prognostic algorithm, (4) provide cost-of-illness data of ON.
ON-COLOUR methodology will imply 9 WPs with focus on ON epidemiological descriptive and analytical studies, the search for vessel disorders, CSF and serum cytokines with vasoactive action, a cost and quality of life studies, and the ultimate development of a prognostic algorithm to optimize ON care.
ON-COLOUR will go beyond the state of the art for (1) scientific knowledge as it will contribute to the refinement of diagnostic criteria, incl., MS and NMOSD, will disclose/enhance knowledge about vessel disease in ON, will disclose prognostic factors, (2) technical knowledge (use of ultrasound in the investigation of inflammation in optic nerve), (3) education, (4) patients’ care through the application of a multidisciplinary integrated algorithm.
ON-COLOUR Research Team consists of neurologists, ophthalmologists and rheumatologists with specific expertise in optic neuropathies, located at the Universities of Ferrara (PI), Naples, Sassari and Udine, and including the IRCCS Casa Sollievo Sofferenza, S. Giovanni Rotondo (FG).
Dettagli progetto:
Referente scientifico: Pugliatti Maura
Fonte di finanziamento: Bando PRIN 2022
Data di avvio: 18/10/2023
Data di fine: 18/10/2025
Contributo MUR: 115.662 €
Cofinanziamento UniFe: 26.595 €
Partner:
- Università degli Studi di FERRARA (capofila)
- Università degli Studi di UDINE
- Università degli Studi di Napoli Federico II
- Università degli Studi di SASSARI